Lower Extremity Functional Scale (LEFS)

PURPOSE

The test can be used to evaluate the impairment of a patient with lower extremity musculoskeletal or disorders. Can be used clinically to measure the patients’ initial function, ongoing progress, and outcome as well as to set functional goals.

BODY PART ICF DOMAIN

Lower Extremity Activity

POPULATIONS

Conditions:

  • Stroke, Osteoarthritis, Joint Pain and Fractures, Chronic Pain

Age ranges

  • Adult

KEY DESCRIPTIONS

  • Questionnaire containing 20 questions about a person’s ability to perform everyday tasks. Scoring scale 0-80.
  • All 20 items are scored with a maximum score 4 for each item.
  • The columns on the scale are summed to obtain a final score.
  • Patients are provided with 20-item instrument on paper and instructed to indicate their current level of difficulty with each activity.

ADMINISTRATION 

  • Cost: free
  • Time to administer: 5 minutes
  • Required training: no training

YOU CAN USE THIS FORM BELOW TO ASSESS YOUR PATIENT AND PRINT IT OUT OR SAVE AS PDF FILE.





EVIDENCE

Reliability

Internal reliability for the LEFS is excellent (α=0.96). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31).

Validity

The LEFS is a valid tool as compared to the SF-36.

Responsiveness

  • The minimum detectable change (MDC) for the LEFS is 9 points. That is, a change of more than 9 points represents a true change in the patient’s condition.
  • The minimum clinically important difference (MCID) for the LEFS is 9 points. That is, “Clinicians can be reasonably confident that a change of greater than 9 points is… a clinically meaningful functional change.”
  • The capacity of the LEFS to detect change in lower-extremity function appears to be superior to that of the SF-36 physical function subscale, as indicated by higher correlations with an external prognostic rating of change.
  • The LEFS has good measurement properties–namely test-retest reliability and  cross-sectional construct validity–and it could be an alternative to WOMAC-PF.

LITERATURE

  • Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83. 

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